Mercy Clinic-Springfield Communities

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

A01264 Issued in AR

Legal business name

MERCY CLINIC-SPRINGFIELD COMMUNITIES

Doing business as

Mercy Clinic-Berryville-Walmart

Practice address

1000 W Trimble Ave
Berryville, AR 72616-4603

Phone

(870) 423-4472

Fax

(870) 423-7178

NPI assigned

Oct 21, 2010

Last updated

Aug 13, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Donn E. Sorensen

Title

Executive Vice President, Coo

Phone

(417) 820-6556

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• MERCY CLINIC-BERRYVILLE-WALMART Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1287619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376352000000",
    "number": "1083924294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2580",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658012580",
            "telephone_number": "417-829-4620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W TRIMBLE AVE",
            "city": "BERRYVILLE",
            "state": "AR",
            "postal_code": "726164603",
            "telephone_number": "870-423-4472",
            "fax_number": "870-423-7178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY CLINIC-SPRINGFIELD COMMUNITIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-21",
        "last_updated": "2013-08-13",
        "status": "A",
        "authorized_official_last_name": "SORENSEN",
        "authorized_official_first_name": "DONN",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT, COO",
        "authorized_official_telephone_number": "417-820-6556"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A01264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083924294",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MERCY CLINIC-BERRYVILLE-WALMART",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mercy Clinic Springfield Communities (Mercy Clinic General Surgery-Berryville)
• Mercy Clinic Springfield Communities (Mercy Clinic Ear, Nose & Throat-Berryville)
• Mercy Clinic Springfield Communities
• Mercy Clinic Springfield Communities (Mercy Radiology Berryville)
• Mercy Clinic Springfield Communities (Mercy Clinic-Family Medicine Berryville)
• Mercy Health Northwest Arkansas Communities
• Mercy Home Health Berryville (Mercy Hospice)
• Mercy Home Health Berryville (Mercy Home Health)
• Mercy Hospital Berryville
• Mercy Hospital Berryville

• Family Nurse Practitioner in Berryville, AR
• Providers in Berryville, AR by specialty
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.